The Short Version of the Italian Maastricht Vital Exhaustion Questionnaire (MVEQ): Psychometric Properties and Relationships with Anxiety, Depression, and Stress in a Community Sample of Older Adults.

Vital Exhaustion (VE) refers to a physical and mental state of excessive fatigue, feelings of demoralization, hopelessness, and increased irritability. The short form of the Maastricht Vital Exhaustion Questionnaire (MVEQ) is a widely used measure to assess VE. Despite its utility is broadly recognized, the validity and reliability of the scale have yet to be examined in the Italian context. The present study aimed to evaluate the psychometric properties of the shortened MVEQ in a community sample of Italian older adults. A total of 722 older adults (Mage = 72.97, SD = 7.71; 60.4% females) completed the MVEQ, as well as other self-report questionnaires assessing anxiety, depression and stress in order to evaluate the criterion-related validity of the scale. A confirmatory factor analysis (CFA) was conducted to examine the original MVEQ latent structure. Internal consistency was assessed through model-based omega coefficient. Test-retest reliability was examined by re-administering the MVEQ after three months to a subsample of 568 participants. Factorial invariance tests across gender were conducted by means of multi-group CFAs. The one-factor model showed an acceptable fit to the data. The MVEQ yielded a reliable total score (ω = 0.822) and showed moderate-to-large correlations with measures of anxiety, depression, and stress (r range 0.30 to 0.75, ps < 0.001). Test-retest reliability was supported by an Intraclass Correlation Coefficient (ICC) of 0.661. Lastly, the scale was factorially invariant across gender. Overall, the MVEQ provided evidence of reliability and criterion-related validity in a sample of Italian older adults and may be useful for both clinical and research practices.

Determinants of the intention to donate umbilical cord blood in pregnant women.

BACKGROUND AND OBJECTIVES: Umbilical cord blood (UCB) donation is a behaviour promoted by many countries' health systems. However, UCB donation is not a widespread behaviour among expectant mothers, and little is known about the reasons that may lead to it. The aim of the present study was to analyse the contribution of Theory of Planned Behaviour (TPB) variables among both primiparous and multiparous women in predicting intention to donate UCB. MATERIALS AND METHODS: Three hundred seventy-six expectant mothers completed questionnaires that captured sociodemographic data, parity, previous donation, attitudes, subjective norms, perceived behavioural control (PBC) and intention to donate UCB. Multigroup analysis structural equation modelling was conducted using Mplus (version 8.02). RESULTS: Multigroup path analyses showed that intentions were strongly predicted by subjective norms and moderately predicted by positive attitudes and PBC in both primiparous and multiparous women. TPB constructs explained 71% of the variance in intentions for both groups. CONCLUSIONS: Future interventions to increase intention to donate among primiparous and multiparous women could primarily consider the influence of partner and significant others in determining positive intentions and secondarily target increasing positive attitudes and perceptions of control.

Positive Orientation and Health-related Quality of Life in Adult Patients Born With Anorectal Malformations.

OBJECTIVES: Anorectal malformations (ARMs) are rare congenital colorectal anomalies, which may have a negative impact on health-related quality of life (HRQoL) due to long-lasting consequences, like fecal incontinence. The aim of the present study was to test whether a pervasive mode of appraising and viewing life experiences from a positive stance (ie, positivity) mediates the effect of fecal continence on HRQoL. METHODS: Participants were enrolled from the Italian Association for Anorectal Malformations. Adult patients with ARMs who completed measures of fecal continence (Hirschsprung Disease/Anorectal Malformation Quality of Life Questionnaire), positivity (Life Satisfaction Scale, Rosenberg Self-esteem Scale, and Life Orientation Test), and mental/physical HRQoL (SF-36) were included. Data were analyzed using the PROCESS macro for SPSS statistical software (Model 4). RESULTS: The study included 66 adult patients with ARMs. Mediated regression analyses showed a significant total effect in which patients with higher fecal continence perceived higher physical (ß = 0.210, SE = 0.038, 95% CI [0.133, 0.286]) and mental HRQoL (ß = 0.226, SE = 0.056, 95% CI [0.115, 0.338]) than patients with lower fecal continence. The indirect effects were also significant, indicating that positivity mediated the impact of fecal continence on physical (ß = 0.026, SE = 0.017, 95% CI [0.002, 0.068]), and mental HRQoL (ß = 0.146, SE = 0.058, 95% CI [0.047, 0.275]). CONCLUSIONS: The findings extend previous literature on ARM patients and additional evidence that an optimistic view of oneself, one's life, and one's future contribute to explain the effects of functional impairments on quality of life.

Knowledge and sources of information on umbilical cord blood donation in pregnant women.

The use of umbilical cord blood (UCB) holds promise for the treatment of a wide spectrum of diseases. However, information on UCB donation is not widespread or accurate among expectant women. The aim of this study is to evaluate pregnant women's knowledge of UCB donation, their main sources of information and their satisfaction with the knowledge possessed. Women (N = 375) in the last semester of pregnancy completed questionnaires evaluating sociodemographics, knowledge of UCB donation, past donation, sources of information, satisfaction with the information and the desire to have received more information. Women were aware of the possibility of donating UCB (97.5%) although, on average, they reported not having enough knowledge of donation possibilities, procedures to be followed and uses of UCB (2.51, on a 5-point scale). Considering knowledge satisfaction, 28% were not at all satisfied. Only 2.8% felt fully prepared and the great majority (75.2%) would have liked to have received more information. The main source of information was the Internet (51.2%). Gynecologists and midwives were indicated by only 24.4% and 18.6% of women, respectively. Age and education were significantly correlated with UCB knowledge. Chi-square tests evidenced that those who reported professional sources of information (gynecologists, obstetricians, prenatal courses) did not need additional information. Conversely, mothers who turned to other mothers for information were more likely to desire further information. Most mothers report the Internet as the main source of information. Providing accurate information through official sources may result in a more positive attitude toward donation.

Exploring the relationship between umbilical blood cord donation and the impact of social distance on altruism and trust.

Allogeneic umbilical cord blood (UCB) donation is a pro-social behaviour directed to strangers that has a certain cost for the donor. Although the promotion of such behaviour is an important goal for many countries' health systems, little is known about the reasons that would lead to it. With this study, we explored how the impact of social closeness on altruism and trust could be related to UCB donation in a sample of new-mothers (N = 167). Participants played hypothetical Dictator and Trust games with socially close (e.g., parents) or distant (e.g., strangers) others. They donated more money to parents and siblings compared to cousins, friends and strangers and they trusted more parents, siblings and friends than cousins and strangers. Interestingly, the lower the impact of social closeness on altruism (i.e., generosity towards socially distant others), the higher the intention and the actual probability of UCB donation. A mediation analysis has shown that the relationship between social closeness on altruism and UCB donation was mediated by objective intention to donate (i.e., having followed all the procedures needed). These findings show that other-oriented motivations towards distant others might have important practical implications in identifying the targets of interventions for the promotion of UCB donation.

Sexual well-being in adolescent and young adults born with arm: the perspective of the patients.

PURPOSE: Sexual well-being and sexual functioning are understudied in patients born with ARM. The aim of this exploratory study was to investigate sexual history, main fears, and problems encountered during sexual relationships. METHODS: Before participating in a sexual education intervention, 21 adolescents or young adults (12 males; mean 28.8; SD 10.6) born with ARM, answered a ten-item questionnaire specifically developed to evaluate sexual well-being. Percentages and Chi-square were calculated. RESULTS: 52.4% were married/had a partner. The majority (71%) declared that had sexual relationships. Mean age of the first sexual relationship was 18.8 (2.7) and 22.7 (3.8) for males and females, respectively. Females reported both more fear and experience of pain during sexual intercourse, compared to males. Main experienced problems and fears for male patients were loss of feces and premature ejaculation, followed by the fear of lack of erection and managing contraception. Main experienced problems and fears in females were loss of feces, pain, lack of desire, and lack of lubrication. In only few cases, patients asked for advices to a pediatric surgeon or to an adult surgeon specialized in ARM. CONCLUSIONS: Adult and adolescent patients may benefit of andrological/gynecological evaluation, psychological support, and sexual counseling to improve their sexual well-being.

What do pediatric surgeons think about sexual issues in dealing with patients with anorectal malformations? The ARM-Net consortium members' opinion.

PURPOSE: Since pediatric surgeons aim to follow their patients with anorectal malformations (ARM) into adulthood the aim of this study was to investigate how pediatric surgeons deal with sexual issues related to ARM. METHODS: In 2018, a questionnaire was developed by the working group "Follow-up and sexuality" of the ARM-Net consortium and sent to all consortium-linked pediatric surgeons from 31 European pediatric surgical centers. Obtained data were statistically analyzed. RESULTS: Twenty-eight of 37 pediatric surgeons (18 males/10 females) answered the questionnaire. The majority of pediatric surgeons (82%) think they should talk about sexual issues with their patient. More than 50% of pediatric surgeons do not feel at all or only moderately confident discussing the topic of sexuality. Most pediatric surgeons require more support (96%) and wish to be trained in sexuality and sexual issues (78%) to feel confident towards their ARM-patients/parents. For optimal care, sexual issues with ARM-patients should be managed by a multidisciplinary team. CONCLUSIONS: Pediatric surgeons feel that sexuality is an important issue for their ARM-patients, which they are primarily responsible of but should be managed in concert with a multidisciplinary team. A training in sexuality is wished to feel more confident about this specific issue.

Sleep quality as predictor of BMI in non-depressed caregivers of people with dementia.

PURPOSE: Although most cross-sectional and longitudinal studies of children and adolescents have found a link between short duration of sleep and obesity, the literature related to adults provides a non-consensual framework. The aim of the present study was to examine the association between sleep quality and BMI in a population of caregivers looking after people suffering from dementia, with a view to identifying the moderating role of depressive symptoms in the relationship between sleep problems and BMI. METHODS: A total of 117 subjects took part in the study, filling in a Sociodemographic Questionnaire, the Pittsburgh Sleep Quality Index, the Eating behavior Questionnaire and The Center for Epidemiologic Studies-Depression. RESULTS: Depressive symptoms were greater in females than in males. The sample was divided into two subgroups based on depressive-symptom scores. Only within the subsample with low depressive symptoms, higher sleep disturbances influenced BMI positively. Within this subsample of participants with low depressive symptoms, the variables that seem to play a pivotal role in explaining a high BMI are: female gender, sleep problems, and diet quality, while within the subsample with high depressive symptoms only the female gender factor was found to influence BMI. CONCLUSIONS: Depressive symptoms seem to act as moderators in the relationship between sleep and BMI. They should be evaluated to identify the risk of high BMI, and to differentiate clinical intervention, at least in this population, which experiences the stress of caregiving chronically, though not suffering from clinical eating disorders. LEVEL OF EVIDENCE: Level II, cross-sectional study.

The relationship between caregiving self-efficacy and depressive symptoms in family caregivers of patients with Alzheimer disease: a longitudinal study.

BACKGROUND: Caregiving for a relative with dementia has been associated with negative consequences for mental health. Self-efficacy has been shown to correlate negatively with depression but the long-term association between caregiver burden, caregiver self-efficacy, and depressive symptoms, remains still largely unexplored. The aim of the present study was to evaluate whether different self-efficacy domains partially mediated the relationship between caregiving burden and depression. METHODS: A three-wave design was used, with initial assessment and follow-ups three months later and one year later. One hundred seventy caregivers of patients with AD responded to measures of caregiver burden, caregiving self-efficacy, and depressive symptoms. Data were analyzed by means of structural equation models. RESULTS: The tested model provided support for the guiding hypothesis. Burden at the time of the first assessment (T1) significantly influenced depression one year later and the relationship between burden at time one and depressive symptoms one year later was partially mediated by self-efficacy for controlling upsetting thoughts. CONCLUSIONS: The findings of the present study provide evidence that, along a considerable length of time, the effects of caregiver burden on depressive symptoms can be explained by the caregivers' efficacy beliefs in controlling upsetting thoughts related to the caregiving tasks. Interventions for caregivers of patients with AD may help them in tackling negative thoughts about the caregiving role.

Transition from childhood to adolescence: Quality of life changes 6 years later in patients born with anorectal malformations.

BACKGROUND/PURPOSE: Disease-specific quality of life (QoL) may be more or less relevant when children enter preadolescence/adolescence. Few attentions have been given to development and transition periods. Aim of the present longitudinal study is to evaluate ARM specific changes in QoL and the stability of QoL over 6 years. METHODS: Questionnaires were sent to families of the AIMAR Association (in 2007 and in 2013/2014). They included the Hirschsprung's Disease/ARM QoL Questionnaire (HAQL, [1]). Rank correlations and within group comparisons for the HAQL subscales were conducted analyzing the scores of time 1 vs time 2. Gender effects were tested. RESULTS: 134 parents answered the questionnaires at time 1 and 73 at time 2. Results of the repeated Analyses of Variance indicated improvements in the continence subscales ("Presence of Diarrhea," "Fecal Continence"). QoL significantly worsened in "Social and Emotional Functioning" and in "Body Image" areas. The analysis of stability of change indicates that QoL scores remain stable, with the exception of the Body Image area. CONCLUSIONS: Despite improvements in the continence areas, parents reported worse levels of QoL in the psychosocial areas, as their child grow. As patients grow, they might have more difficulties in daily and social activities, and feel more frequently ashamed and more dissatisfied with their body.

The Relationship between Body Mass Index, Body Dissatisfaction and Mood Symptoms in Pregnant Women.

Background: High body mass and adiposity during pregnancy can contribute to psychological distress, and body dissatisfaction may be a potential underlying mechanism of this association. Objective. This study aimed to evaluate the mediational role of body dissatisfaction in the relationship between body mass index (BMI) and depressive and anxious symptoms, respectively. Methods: Given the cross-sectional design of this study, two alternative models were investigated, positing that BMI was related to depressive (Model 1a) and anxious symptoms (Model 2a), which, in turn, predicted body dissatisfaction. Seventy-two pregnant women in the third trimester of pregnancy completed the Body Image Disturbance Questionnaire, the Beck Depression Inventory-II and the State-Trait Anxiety Inventory, as well as a demographic form assessing their BMI. Results: As hypothesized, body dissatisfaction mediated the relationship between BMI and psychopathological symptoms. Moreover, the alternative models of reverse mediation were also significant, suggesting that psychopathological symptoms mediated the relationship between BMI and body dissatisfaction. Findings from both the hypothesized and alternative models suggested that, on the one hand, higher distress symptoms associated with body dissatisfaction would result from high BMI and, on the other hand, that body dissatisfaction may result from the effect of BMI on distress symptoms. Conclusions: The present study suggests that body image theory and practice should be implemented by the inclusion of evidence-based clinical interventions for promoting psychological well-being during the antenatal period.

Measuring childbirth-related posttraumatic stress disorder: Psychometric properties of the Italian version of the City Birth Trauma Scale (City BiTS).

OBJECTIVE: The City Birth Trauma Scale (City BiTS) assesses postpartum posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria. Although it has been validated worldwide, predictive validity has not been previously examined. Moreover, no Italian version of the scale exists. This study aimed to test the bifactor latent structure and alternative models, internal consistency, test-retest reliability, convergent validity, divergent validity, and predictive validity of the City BiTS. METHOD: Women (N = 629) who had given birth within the past 3 months completed an online survey including sociodemographic and obstetric characteristics, the City BiTS, the Impact of Event Scale-Revised, and the Edinburgh Postnatal Depression Scale. After 3 months, women completed the City BiTS again and reported their intention to breastfeed during the 1-year postpartum. RESULTS: Exploratory factor analysis confirmed the two-factorial structure. In confirmatory factor analysis, the two-factorial solution showed the best model fit. Internal consistency was good to excellent for the subscales and the total scale. Correlation analyses showed strong convergent validity with the Impact of Event Scale-Revised, high divergent validity with the Edinburgh Postnatal Depression Scale, high test-retest reliability, and good predictive validity with the intention to exclusively breastfeed. Moreover, the Birth-Related Symptoms subscale distinguished between different types of delivery. CONCLUSIONS: The City BiTS-Italian is the first measure evaluating and diagnosing childbirth-related PTSD symptoms based on Diagnostic and Statistical Manual of Mental Disorders (5th ed.) in Italy. The factorial structure and validity reported in other cultural contexts were confirmed; moreover, findings add evidence to the scale's temporal stability and predictive validity. Besides contributing to clinical purposes, the City BiTS-Italian will facilitate international comparability regarding the prevalence of PTSD following childbirth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PAIN SEVERITY AND DEPRESSIVE SYMPTOMS IN ENDOMETRIOSIS-PATIENTS: MEDIATION OF NEGATIVE BODY AWARENESS AND INTEROCEPTIVE SELF-REGULATION.

Endometriosis-related pain may be associated with depressive symptoms. Although a growing body of evidence supports this association, the underlying mechanisms are still largely unclear. Impaired perceptions of bodily external and internal stimuli may be involved in this process. This study aims to assess the mediating role of two facets of interoception - the awareness of negative body signals and interoceptive self-regulation - in the association between pain severity and depressive symptoms among women with endometriosis. A total of 301 patients who reported a diagnosis of endometriosis were recruited from an endometriosis and chronic pelvic pain outpatient university clinic and through patient associations and completed self-reported instruments. A parallel mediation analysis was conducted. Almost half of women (48.2%) reported depressive symptoms above the self-rating scale cut-off values. Pain severity significantly predicted depressive symptoms (ß =0.39, 95% bootstrap CI [0.719, 1.333]). Negative body awareness (ß =0.121, 95% bootstrap CI [0.174, 0.468]) and interoceptive self-regulation (ß = 0.05, 95% bootstrap CI [0.035, 0.252]) partially mediated this relationship. Our findings indicated that pain may interfere with the perception of the body as a source of calmness and safety, limiting the individual's ability to effectively regulate emotions. Future research should further explore these mechanisms and evaluate the efficacy of interventions focusing on interoceptive sensibility to enhance the psychological well-being of endometriosis patients. PERSPECTIVE: This article investigates for the first time the potential role of two facets of interoceptive sensibility in the relationship between pain severity and depressive symptoms in women with endometriosis. These findings may contribute to advancing knowledge about mechanisms involved in the complex pain-depression cycle.

Quality of life in children and adolescents with anorectal malformation.

PURPOSE: Quality of life (QOL) is an important endpoint in health outcomes research, especially in pediatric chronic conditions. While some studies suggest that patients with ARM report a lower level of physical and psychosocial QOL, as compared to healthy peers, not all research shows this consistently. The aim of this study was to compare the QOL of Italian children and adolescents with ARM to the QOL of a large control sample of healthy peers. METHODS: Parents of 109 children with ARM and 336 schoolchildren, completed the Pediatric Quality of Life Inventory. Analysis of variances were used to compare the groups. RESULTS: Compared to healthy peers, children with ARM showed lower emotional functioning (F = 8,41; p = .004), social functioning (F = 4,9; p = .027) and school functioning (F = 14,7; p = .000). In the adolescent group, females had a worse QOL in the physical functioning domain (F = 5,01; p = .03) than males, independent of group membership. CONCLUSIONS: While children with ARM show a more impaired QOL compared to their peers, this difference does not emerge in the adolescent group. Our results are consistent with previous findings which hypothesize that while patients with ARM face more difficulties during childhood, by adolescence they may have learned to overcome these difficulties.

Does mothers' perception of social support mediate the relationship between fecal incontinence and quality of life of the child?

PURPOSE: Fecal incontinence is a common problem in children and adolescents with anorectal malformation (ARM) and may negatively impact psycho-social well-being. Mothers' perception of social support has been proved to contribute to children's quality of life (QOL). Considering ARM studies, the role of family and social resources have received little attention. The aim of the present study was to analyze whether mothers' perception of social support mediates the impact of child fecal incontinence on his/her QOL. METHODS: One hundred and nine mothers with a child born with ARM (aged 6-15 years old; mean age = 11 years) completed questionnaires including the fecal incontinence subscale of the Hirschsprung's Disease/Anorectal Malformation QOL Questionnaire, the Pediatric QOL Inventory, and a social relationship questionnaire. Structural equation models were used to explore the relations hypothesized. RESULTS: No differences were found in the QOL scores across gender. The hypothesized model fits the data well; mothers' perception of social support partially mediated the relationship between fecal incontinence and QOL. CONCLUSIONS: An important direction for pediatric surgeons and their interdisciplinary teams may be to develop strategies to strengthen mothers' social relationships.

Predicting intention and maintenance of breastfeeding up to 2-years after birth in primiparous and multiparous women.

OBJECTIVES: Breastfeeding up to 2-years has been associated with short and long-term health benefits for both newborns and mothers. However, few women breastfeed up to 2-years after birth. This study extends previous research on the theory of planned behaviour (TPB) examining the predictors of intention and maintenance of breastfeeding up to 2-years in both primiparous and multiparous women. DESIGN: 155 pregnant women participated in this longitudinal study. METHODS: Expectant mothers completed a questionnaire and then 2-years after the child's birth were asked to report breastfeeding behaviour. Interactions among parity and TPB constructs were examined. RESULTS: Attitudes, descriptive and injunctive norms, and perceived behavioural control (PBC) explained 58% of the variance in mothers' intention to breastfeed. Attitudes were the strongest predictor, followed by PBC, descriptive norms and parity. A significant interaction was found between parity and PBC, showing that PBC was only a significant predictor of intention to breastfeed at 2-years in multiparous women. Intentions predicted breastfeeding behaviour at 2-years. CONCLUSION: Promoting intentions may be a useful way to increase breastfeeding duration to 2-years and targeting attitudes and norms may be one way to increase intentions. Further, targeting PBC may also be useful to increase intentions, but only in multiparous women.

Predicting postpartum depressive symptoms by evaluating self-report autonomic nervous system reactivity during pregnancy.

OBJECTIVE: Altered self-reported autonomic reactivity is associated with worse mental health in the general population. Although dysfunctional changes in ANS during pregnancy have been investigated in relation to depressive symptoms, no studies addressed the relationship between self-report autonomic reactivity during pregnancy and depressive symptoms after the delivery. The present study aimed to assess the impact of prepartum self-reported autonomic reactivity on the development of postpartum depressive symptoms. METHODS: In this longitudinal study, 170 women were assessed during pregnancy (i.e., second or third trimester) and after childbirth (i.e., one month after the delivery). Self-reported autonomic reactivity was assessed through the Body Perception Questionnaire - Short Form that evaluates the autonomic functions related to organs above (i.e., supradiaphragmatic reactivity) and below (i.e., subdiaphragmatic reactivity) the diaphragm. In addition, prepartum and postpartum depressive symptoms were evaluated using the Patient Health Questionnaire - 9. RESULTS: Findings showed that higher prepartum supradiaphragmatic reactivity predicted higher depressive symptoms in the postpartum period (ß = 0.112, p = 0.009) after controlling for prepartum depressive symptomatology and other potential covariates. CONCLUSIONS: Evaluation of self-reported autonomic activity may be a useful tool to identify antenatally women at risk of postpartum depressive symptoms. Future studies are needed to evaluate the effectiveness of interventions aimed at reducing the threat-responsive autonomic reactivity at rest and improving adaptive autonomic regulation to prevent postpartum depression.

A prospective study on body image disturbances during pregnancy and postpartum: the role of cognitive reappraisal.

Background: During pregnancy, body size rapidly modifies over a relatively short period. Literature emphasizes the need to identify the factors that influence body image during peripartum as the extent of women's adaptation to these changes has significant repercussions on both mother's and newborn's health. Emotion regulation strategies (i.e., expressive suppression and cognitive reappraisal) were linked to body image in the general and clinical population, but no studies were conducted in the peripartum. The present study aims to investigate the longitudinal impact of prepartum body image disturbances on postpartum body image disturbances and to evaluate the mediational role of emotional regulation strategies. Methods: A total of 133 pregnant women completed a three-phase longitudinal study. Women answered online questionnaires during the second (T1) and the third (T2) trimesters of pregnancy, and at about 6 months postpartum (T3). Results: Findings indicated that body image disturbances at T1 were a significant predictor of body image disturbances in the postpartum (1 year after the first assessment). Moreover, cognitive reappraisal measured at T2 partially mediated this relationship: body image disturbances in the second trimester of pregnancy were linked to less use of cognitive reappraisal in the third trimester of pregnancy, and this, in turn, was associated with worse body image disturbances at 6 months after birth. Conclusion: Findings of this longitudinal study highlight the importance of assessing body image disturbances during pregnancy to early identify women at risk, and suggest cognitive reappraisal as a possible target intervention.

Longitudinal association between saliva and hair cortisol concentration: A systematic comparison.

Cortisol assays from hair have become increasingly common in psychoneuroendocrinological research as indicators of long-term output relevant to stress and health outcomes. Comparisons of hair cortisol concentration (HCC) with salivary samples have produced mixed findings, and it remains unclear which aspects of the diurnal salivary profile correspond most closely to HCC, and what time intervals between saliva and hair sampling are most relevant, taking the rate of hair growth into account. This longitudinal study aimed to evaluate the correspondence between HCC and parameters of total salivary cortisol output in the morning (CARauc and CARi) and during the rest of the day excluding the early morning period (DAYauc), by systematically studying three time periods - two weeks, four weeks, and six weeks - before hair sampling. At each time period, 54 female university students (mean age: 20.85 ± 1.16 years) provided three saliva cortisol samples on day 1 at 11 am, 3 pm, at bedtime, then two samples the following day on waking and 30 min after awakening. Hair strand collection (1 cm nearest the scalp) took place two weeks after the last saliva sample. Results of multivariable regressions indicate that HCC was consistently associated with DAYauc for all three time periods and with the aggregate DAYauc across days after adjusting for age, body mass index, smoking, oral contraceptive use, hair washing frequency and hair treatments. The strongest associations were found for DAYauc two weeks before hair sampling (ß = 0.578, p < 0.001) and the aggregated DAYauc across all three time periods (ß = 0.596, p < 0.001), although the confidence intervals overlapped those for four and six week analyses. There was no significant association between HCC and either CARauc or CARi. Our study confirms that hair cortisol could be a reliable retrospective biomarker of basal and long-term cortisol output secretion at least up to six weeks earlier. The results contribute to a better understanding of the different associations between HCC and salivary cortisol in the morning and the rest of the day, while also having implications for the use of HCC as an outcome measure in intervention and treatment research.

The impact of prepartum pandemic-related perceived stress on anxiety symptoms in the postpartum: The role of perceived childbirth experiences.

Postpartum anxiety is a significant component of postpartum maternal distress and is related to adverse outcomes for both the mother and the child. Although previous research reported higher anxiety symptoms in pregnant women during the Covid-19 pandemic, no studies evaluated the negative impact of pandemic-related perceived stress on postpartum anxiety symptomatology over time. This study aimed to examine the impact of prepartum pandemic-related stress on postpartum anxiety and to evaluate the role of subjective labor and delivery experiences on this relationship. A sample of 172 pregnant women completed an online questionnaire evaluating pandemic-related perceived stress and anxiety symptoms in the second or third trimester of pregnancy. In the postpartum, they completed a second questionnaire retrospectively evaluating their childbirth experience and assessing anxiety symptoms in the last two weeks. A mediation analysis was conducted. Prepartum pandemic-related perceived stress was significantly associated with postpartum anxiety symptoms. Moreover, childbirth experiences significantly and partially mediated this relationship. Findings highlighted the importance of evaluating perceived stress levels during pregnancy to prevent negative consequences on postpartum mental health. Clinicians need to foster better management of factors included in the childbirth experience that may potentially trigger or counteract anxiety risk.